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Sitting Docs Have Happier Patients
Date:4/7/2010

People perceive physicians stay longer when they aren't standing, study finds

WEDNESDAY, April 7 (HealthDay News) -- When it comes to doctor-patient relationships, new research suggests that patients would be happier if their doctors would just sit down and stay awhile.

And for doctors, taking a seat doesn't necessarily have to add time to their day. The researchers found that when doctors sat down during a hospital visit, patients thought the doctors had stayed longer than they actually had.

"Patients perceived that sitting physicians were in the room about 40 percent longer than they were," said the study's senior author, Dr. Paul Arnold, director of the Spinal Cord Injury Center at the University of Kansas Medical Center in Kansas City.

"And, after a while, we started noticing that the patients had almost no negative comments about the physicians who would sit down," Arnold added. "So, there was both a quantitative and qualitative difference in patients' perception."

Dr. Ronald Epstein, director of the Rochester Center to Improve Communication in Healthcare at the University of Rochester Medical Center in New York, said he wasn't surprised by the finding.

"This is in the lore of medical training," Epstein said. "During school, we're told that it really changes the dynamic of interactions." But until now, he said, there's hasn't really been any research to support the idea.

"It's important to put yourself at the same level as your patient," he said. "For a patient, it can be a frightening, disempowering feeling to have a group of people standing over you," referring to what can happen in teaching hospitals when a group of doctors enters a patient's room.

"Sitting down is a gesture of accommodation, similar to smiling," Epstein said. "I think patients do appreciate it, and that it allows them to express their concerns more openly."

For the study, which has not been published, Arnold and his colleagues followed physician interactions with 120 adult, post-operative, neurosurgical patients. All of the patients had an established relationship with their doctor.

One group of patients was visited by a doctor who stood, and patients in the other group were seen by a doctor who sat during the visit. Visit times were measured with a stop watch.

On average, standing doctors spent 1 minute 28 seconds at their patients' bedsides. Sitting doctors actually spent slightly less time in the room, averaging 1 minute 4 seconds.

But whether the doctors stood or sat, their patients' perception was significantly different from reality.

Patients whose doctors stood thought the doctor spent about 3 minutes 44 seconds in the room. Those with sitting doctors believed their doctor was present for an average of 5 minutes 14 seconds, the study found.

The researchers then asked a smaller group (38 patients -- 20 who had a sitting doctor and 18 with a standing doctor) about their feelings regarding the bedside meetings. For a physician who sat down, 95 percent of the comments were positive, compared with 61 percent positive comments for doctors who stood.

Patients said they felt that doctors who sat down took time to listen and that all of their questions had been answered. When describing doctors who stood, patients said such things as, "He was in and out of my room before I even knew what was going on" and "I didn't have time to ask the doctor any questions."

"I think physicians should try to sit down when they can," Arnold said. "It puts the physician and the patient face-to-face, and it seems like you're willing to stay a little longer. If you're standing, it seems like you're in a rush."

More information

The American Academy of Family Physicians has advice on communicating with your doctor.



SOURCES: Paul M. Arnold, M.D., professor, neurosurgery, and director, Spinal Cord Injury Center, department of neurosurgery, University of Kansas Medical Center, Kansas City, Kan.; Ronald M. Epstein, M.D., family physician and director, Rochester Center to Improve Communication in Health Care, University of Rochester Medical Center, Rochester, N.Y.


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